Contact — Occupational Derm & Patch Testing

A nurse with chronic hand eczema worsens after frequent sanitizer use. Patch test is negative. Most likely diagnosis?

A hairdresser develops swollen, weeping eczematous eyelids; hands are mildly dry. Most likely allergen?

A construction worker with dorsal foot dermatitis sparing toe webs. Most likely culprit in shoes?

A patient reacts to multiple fragranced products. Which screening allergens best detect this?

A 30-year-old with recurrent earlobe dermatitis from costume earrings. Office test to identify metal release?

A 42-year-old with chronic hand eczema worsens wearing latex gloves. Patch test positive to thiuram mix. Best glove change?

A cement worker has fissured hands and forearms; patch test positive to potassium dichromate. Preventive measure?

A patient’s nummular plaques worsen under hydrocortisone cream; patch test positive to tixocortol pivalate. Management?

A machinist develops follicular papulopustules on forearms after using cutting oils. Diagnosis?

A patient with suspected photoallergic dermatitis after using ketoprofen gel. Best diagnostic method?

Nail technician with periungual dermatitis and itchy eyelids. Most likely allergen group?

A patient reacts to multiple “hypoallergenic” moisturizers and baby wipes. Common preservative culprit?

Patch testing basics: when is the first standard reading performed after application?

How is a strong positive patch test scored?

A 24-year-old gets severe dermatitis from a “black henna” tattoo. Likely allergen and consequence?

An atopic baker with hand dermatitis worsened by doughs. Likely mechanism?

A 66-year-old with leg ulcers uses topical neomycin and bacitracin; now eczematous rim dermatitis. Best step?

A dental worker develops finger dermatitis. Patch test positive to epoxy resin (DGEBA). Workplace change?

A runner has papules where kinesiology tape contacts skin. Likely allergen?

A patient with recurrent perioral dermatitis after certain toothpastes/candies. Common flavor allergen?

A gardener with swollen, pruritic eyelids after weed trimming. Likely plant family?

Photodistributed pruritic eczematous eruption after new sunscreen. Most likely mechanism/allergen?

A 50-year-old with jewelry dermatitis is counseled on diet to reduce flares. Evidence-based advice?

A patient’s back shows numerous doubtful/weak positives to many allergens at 48 h with very inflamed skin. Term and approach?

A seamstress develops axillary/waistband dermatitis from clothing. Likely causes?

A man with chronic stasis dermatitis begins daily antibiotic ointment; dermatitis worsens with weeping crust. Patch test likely positive to?

Which feature favors irritant over allergic hand dermatitis?

A healthcare worker develops urticaria and rhinoconjunctivitis minutes after donning powdered latex gloves; patch test negative. Mechanism?

A patient reacts to “-caine” anesthetic creams. Which screening allergen detects this?

An auto painter has hand dermatitis; patch test positive to isocyanates is rare. More typical occupational disease from isocyanates?

You suspect relevant allergy to nickel earrings. Which statement reflects “relevance” on the report?

A 35-year-old cyclist develops buttock/thigh dermatitis at chamois contact. Most likely allergen?

A patient with extensive photoallergy to ketoprofen asks about cross-reactivity. Which product is risky?

Optimal management for chronic hand ACD in a cleaner repeatedly exposed to wet work and detergents?

A patient with new glucose sensor develops perilesional eczema. Reported culprit in some devices?

Which occupational skin disease requires evacuation from cold-water immersion due to anaphylaxis risk?

A 29-year-old graphic artist has hand dermatitis; patch positive to colophony and abietic acid. Cross-exposures to avoid?

In suspected textile dye allergy, which body sites are most suggestive?

Patient with hand eczema insists on “hypoallergenic” labeling guarantee. Best counsel?

You plan patch testing in a patient on chronic prednisone 40 mg/day. What is the concern?